Company: Elevance Health
Location: Costa Mesa
Posted on: November 19, 2022
+ Job Family: Medical and Clinical
+ Type: Full time
+ Date Posted:Nov 09, 2022
+ Req #: JR23188
+ California, California
+ Hawaii, Hawaii
+ Arizona, Arizona
+ Nevada, Nevada
+ Colorado, Colorado
+ Oregon, Oregon
+ Washington, Washington
+ Alaska, Alaska
+ Idaho, Idaho
**Reviewer - Therapy Services**
**Work hours as follows** :
+ **HST** 6:30 AM - 3 PM
+ **AKST** 8:30 AM - 5 PM
+ **PST** 9:30AM - 6PM
+ **MST** 10:30AM - 7PM
+ **CST** 11:30AM - 8PM
+ **EST** 12:30PM - 9PM
The Reviewer - Therapy Services is responsible for the review of
medical records to determine if requests for therapy services
(physical therapy, occupational therapy, and/or speech-language
pathology) were medically necessary and filed appropriately.
+ Follows the system guidelines that makes decisions on approval
for care for a patient.
+ Processes system generated decisions for authorization requests,
meeting all contract requirements, processes, and operational unit
goals to ensure customer satisfaction.
+ Documents findings, develops analyses, and submits reports to the
appropriate departments in accordance with government regulations
+ Researches and obtains additional data, consults with clinical
reviewers and medical directors, when necessary.
+ Acts as a resource for internal and external customers.
+ May participate in intradepartmental teams, projects, and
+ Maintains quality and productivity standards and ensures reviews
are conducted within required time frames.
+ Requires graduate of a college level program in Physical Therapy,
Occupational Therapy, and minimum of 1 year of clinical experience;
or any combination of education and experience, which would provide
an equivalent background.
+ Current active unrestricted license or certification as a
Physical Therapist, Occupational Therapist, in the state that you
+ Certification and/or licensure appropriate to field of specialty
+ Pediatric Developmental Delay and/or Outpatient Orthopedic
**Applicable to Colorado Applicants Only**
Hourly Pay Range*: $27.54/hr - $36.14/hr
Actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level.
* The hourly or salary range is the range Elevance Health in good
faith believes is the range of possible compensation for this role
at the time of this posting. The Company may ultimately pay more or
less than the posted range. This range is only applicable for jobs
to be performed in Colorado. This range may be modified in the
future. No amount is considered to be wages or compensation until
such amount is earned, vested, and determinable under the terms and
conditions of the applicable policies and plans. The amount and
availability of any bonus, commission, benefits, or any other form
of compensation and benefits that are allocable to a particular
employee remains in the Company's sole discretion unless and until
paid and may be modified at the Company's sole discretion,
consistent with the law.
For URAC accredited areas the following applies:
+ Requires current, active, unrestricted license in occupational,
speech, or physical therapy to practice as a health professional
within the scope of practice in applicable state(s) or territory of
the United States.
+ Current, active, unrestricted license or certification as a
physical therapist assistant, occupational therapist assistant, or
speech language pathologist assistant in applicable state or
territory of the United States. Unless expressly allowed by state
or federal law or regulation, are located in a state or territory
of the United States when conducting a peer clinical review.
For URAC accredited areas, the following professional competencies
+ Associates in this role are expected to have strong oral, written
and interpersonal communication skills, problem-solving skills,
facilitation skills, and analytical skills.
Please be advised that Elevance Health only accepts resumes from
agencies that have a signed agreement with Elevance Health.
Accordingly, Elevance Health is not obligated to pay referral fees
to any agency that is not a party to an agreement with Elevance
Health. Thus, any unsolicited resumes, including those submitted to
hiring managers, are deemed to be the property of Elevance
**Be part of an Extraordinary Team**
Elevance Health is a health company dedicated to improving lives
and communities - and making healthcare simpler. Previously known
as Anthem, Inc., we have evolved into a company focused on whole
health and updated our name to better reflect the direction the
company is heading.
We are looking for leaders at all levels of the organization who
are passionate about making an impact on our members and the
communities we serve. You will thrive in a complex and
collaborative environment where you take action and ownership to
solve problems and lead change. Do you want to be part of a larger
purpose and an evolving, high-performance culture that empowers you
to make an impact?
We offer a range of market-competitive total rewards that include
merit increases, paid holidays, Paid Time Off, and incentive bonus
programs (unless covered by a collective bargaining agreement),
medical, dental, vision, short and long term disability benefits,
401(k) +match, stock purchase plan, life insurance, wellness
programs and financial education resources, to name a few.
The health of our associates and communities is a top priority for
Elevance Health. We require all new candidates to become vaccinated
against COVID-19. If you are not vaccinated, your offer will be
rescinded unless you provide - and Elevance Health approves - a
valid religious or medical explanation as to why you are not able
to get vaccinated that Elevance Health is able to reasonably
accommodate. Elevance Health will also follow all relevant federal,
state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in
2021, is ranked as one of the 2021 World's Most Admired Companies
among health insurers by Fortune magazine, and a Top 20 Fortune 500
Companies on Diversity and Inclusion. To learn more about our
company and apply, please visit us at careers.ElevanceHealth.com.
Elevance Health is an Equal Employment Opportunity employer and all
qualified applicants will receive consideration for employment
without regard to age, citizenship status, color, creed,
disability, ethnicity, genetic information, gender (including
gender identity and gender expression), marital status, national
origin, race, religion, sex, sexual orientation, veteran status or
any other status or condition protected by applicable federal,
state, or local laws. Applicants who require accommodation to
participate in the job application process may contact
firstname.lastname@example.org for assistance.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from
discrimination under Federal law for job applicants and
+ EEO Policy Statement
+ EEO is the Law Poster
+ EEO Poster Supplement-English Version
+ Pay Transparency
+ Privacy Notice for California Residents
Elevance Health, Inc. is an E-verify Employer
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Keywords: Elevance Health, Costa Mesa , Reviewer-Therapy Services, Healthcare , Costa Mesa, California
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